Patient Rights, Billing & Good Faith Estimates

Your rights as our patient

To be treated with dignity, courtesy, and respect, without discrimination.

To receive a clear explanation of your evaluation findings, your plan of care, its expected benefits and risks, and your alternatives, in terms you understand.

To take part in decisions about your care, to ask questions, and to refuse or stop treatment at any time.

To know the names and credentials of the therapists and staff who treat you.

To privacy and confidentiality of your health information, as described in our Notice of Privacy Practices.

To receive an explanation of charges and, if you are uninsured or self-pay, a Good Faith Estimate of expected charges.

To free language assistance and auxiliary aids, as described in our Nondiscrimination Notice.

To voice a concern or complaint without fear of retaliation, and to have it addressed promptly.

Your responsibilities

PT ReVolution clinicians are dedicated to you and will give you dedicated care. Lasting results are a partnership, so at a minimum we ask you to:

Attend regularly, 2 to 3 times per week, as prescribed in the plan of care you and your therapist agree on.

Be willing to receive hands-on care. Skilled manual therapy is central to our approach. Tell your therapist your comfort limits so they can adjust.

Perform your home exercise program as directed.

Understand that new soreness is expected. As new and improved movement patterns develop, you will likely feel soreness in new areas, and this is often a great sign.

Understand that effective care can cause temporary changes, such as bruising, redness, or tenderness, which usually fade within days.

We also ask you to:

Give us complete and accurate information about your health, medications, and history, and tell us about any changes.

Call us if you have sharp or worsening pain, new numbness or tingling, significant swelling, or anything that concerns you.

Arrive on time, and give us notice if you need to cancel or reschedule.

Provide current insurance information and meet your financial obligations, including copays, coinsurance, and deductibles.

Treat our staff and other patients with respect.

See our two-way commitment.

Insurance and payment

As a courtesy, we verify your insurance benefits before you start care and explain what we learn. Benefit information comes from your plan and is not a guarantee of payment. You are responsible for any amounts your plan does not cover, including copays, coinsurance, deductibles, and services your plan considers non-covered. If you have questions about a bill, call us and we will walk through it with you.

Your Right to Receive a Good Faith Estimate of Expected Charges

Under the law, health care providers need to give patients who don't have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.

You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after you ask.

If you receive a bill that is at least $400 more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate and the bill.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

Notice to consumers: Texas Board of Physical Therapy Examiners

Physical therapists and physical therapist assistants in Texas are licensed and regulated by the Texas Board of Physical Therapy Examiners. Complaints about a licensee may be directed to:

Questions or concerns

We would always rather hear from you first. If something about your care, your bill, or your experience isn't right, ask for the clinic director or contact us: